Little people of America.

Abstract

It had taken over a year of letter writing, grant applications, and visa petitioning, but as the lift doors opened I knew I had finally arrived. . . . Family groups were sitting in the waiting area and among them were several people clearly affected by dwarfism?the little people of America as I came to know them. This was the Department of Medical Genetics at the Johns Hopkins Hospital, Baltimore, USA, and I was beginning my student elective as a clinical clerk, seeing patients with genetically determined disorders. Hupkins, as it is affection? ately known, is a 1000-bed hospital, serving both a large residential section of east Baltimore and acting as a referral centre for rare and complex conditions. In its century of existence it has earned world renown as a teaching and research hospital. The original nineteenth-century red-brick hospital with its marble floors and cupola-roofed entrance has been skilfully incorporated into the modern glass, steel, and concrete clinical buildings. The influence of William Osier, the first professor of medicine, is still strongly in evidence, and during my visit I was to encounter just one of the syndromes originally described by him. Subsequent physicians there have lent their names to numerous clinical signs, while surgeons have pioneered piocedures from the introduction of surgical gloves to the correction of congenital heart malformations. Even the patients at Hopkins have achieved world fame?for example, the cervical tumour of Henrietta Lacks has become the source of the ubiquitous HeLa cell.